European Journal of Gastroenterology & Hepatology最新文献

{"title":"Hepatocellular carcinoma development after hepatitis B surface antigen seroclearance in chronic hepatitis B patients: a 10-year single-center cohort study.","authors":"Naciye Nur Tozluklu, Ümit Karaoğullarindan","doi":"10.1097/MEG.0000000000003233","DOIUrl":"10.1097/MEG.0000000000003233","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B surface antigen (HBsAg) seroclearance is considered a functional cure in chronic hepatitis B (CHB), yet the risk of hepatocellular carcinoma (HCC) may persist. This study aimed to evaluate HCC incidence and identify risk factors after HBsAg seroclearance.</p><p><strong>Methods: </strong>This retrospective single-center cohort included 259 CHB patients who achieved HBsAg seroclearance between 2013 and 2023. Patients with pre-existing HCC were excluded. During follow-up, 22 patients developed HCC. Clinical, demographic, and laboratory variables were analyzed. Independent risk factors were determined using multivariate logistic regression.</p><p><strong>Results: </strong>HCC developed in 22 (8.49%) patients after seroclearance. In multivariate logistic analysis, a higher cirrhosis, age, male sex, platalet count, and hepatitis B score and shorter HBV infection duration were independently associated with HCC development after HBsAg seroclearance ( P  < 0.005). Male sex and older age were significant in univariate analysis but not in multivariate analysis. Markers of liver dysfunction and fibrosis were significantly worse in patients who developed HCC.</p><p><strong>Conclusion: </strong>HBsAg seroclearance reduces but does not eliminate the risk of HCC. Patients with advanced liver disease and high-risk profiles remain vulnerable, underscoring the need for continued, risk-adapted HCC surveillance after seroclearance.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1101-1105"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of molecular adsorbent recirculating system albumin dialysis in the treatment of hepatic encephalopathy associated with liver failure: a meta-analysis.","authors":"Weiying Xiang, Lei Zhang, Zhan Zhang","doi":"10.1097/MEG.0000000000003214","DOIUrl":"10.1097/MEG.0000000000003214","url":null,"abstract":"<p><p>This meta-analysis aimed to systematically evaluate the efficacy (including improvement of biochemical indicators and clinical outcomes) and safety of the molecular adsorbent recirculating system (MARS) in the treatment of hepatic encephalopathy associated with liver failure. PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases were systematically searched from inception to April 2024. Predefined inclusion criteria were used to assess study quality, and statistical analyses were performed using RevMan 5.4. Seven studies were included. Results showed that MARS significantly improved hemoglobin [standard mean difference (SMD): -0.81, 95% confidence interval (CI): -1.42 to -0.19, P  = 0.01], creatinine (SMD: -0.46, 95% CI: -0.68 to -0.24, P  < 0.0001), and international normalized ratio (INR) (SMD: -0.22, 95% CI: -0.43 to -0.01, P  = 0.004). However, effects on albumin (SMD: 0.60, 95% CI: -0.22 to 1.41, P  = 0.15) and bilirubin (SMD: -0.21, 95% CI: -0.78 to 0.35, P  = 0.46) were NS. No significant association was observed between MARS treatment and increased risk of bleeding (risk ratio: 1.23, 95% CI: 0.83 to 1.81, P  = 0.30) or infection (risk ratio: 1.23, 95% CI: 0.97 to 1.56, P  = 0.09). In conclusion, preliminary analysis suggests that MARS may help improve creatinine and INR levels in hepatic encephalopathy patients without significantly increasing bleeding or infection risks. However, because of the limited number and suboptimal quality of included studies and presence of heterogeneity, current evidence is insufficient. Rigorously designed, adequately powered, high-quality randomized controlled trials are needed to validate the precise efficacy and safety of MARS in hepatic encephalopathy treatment.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1008-1016"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early but not serial ustekinumab concentration measurements are associated with clinical outcomes in Crohn's disease and ulcerative colitis: the Stockholm Ustekinumab study (STOCUSTE).","authors":"Haider Sabhan, Francesca Bello, Samer Muhsen, Fredrik Johansson, Alexandra Borin, Charlotte Höög, Ole Forsberg, Christina Wennerström, Sven Almer, Mikael Lördal, Charlotte Söderman","doi":"10.1097/MEG.0000000000003274","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003274","url":null,"abstract":"<p><strong>Introduction: </strong>Ustekinumab (UST), an anti-interleukin-12/23 antibody, is used to treat moderate-to-severe inflammatory bowel disease (IBD). The STOCUSTE study includes IBD patients treated with UST at four teaching hospitals in Stockholm to provide long-term follow-up data. The utility of therapeutic drug monitoring to optimize treatment and correlate the serum concentration of UST with clinical outcomes was investigated in a real-world setting.</p><p><strong>Methods: </strong>This retrospective study includes patients diagnosed with Crohn's disease and ulcerative colitis treated with UST and followed until withdrawal of treatment for any reason or until the end of the study. Concentration data and dosing interval were collected at each follow-up (3, 6, 9, 12, 24, 36, and 48 months) in relation to the presence of remission defined as Physician Global Assessment = 0.</p><p><strong>Results: </strong>A total of 418 patients were included, 322 with Crohn's disease (48% female) and 96 with ulcerative colitis (46% female). UST concentrations were obtained in 229 (55%) patients, while 189 had no measurements. The mean serum concentrations for all were above 1 μg/ml. At 3 months, patients in remission had significantly higher concentrations than nonremitters (P < 0.001). No significant differences were observed at 6 months or later. Within 12 months of concentration result, approximately one-third of patients underwent treatment adjustments, including interval shortening, intravenous reinduction, or discontinuation/switch.</p><p><strong>Conclusion: </strong>In this study, an early (≤3 months) UST concentration was associated with remission, whereas concentrations measured at later time points did not differ between remission and nonremission. In this real-world cohort serial monitoring beyond 3 months showed poor correlation with clinical outcomes.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a simplified dynamic nomogram for preoperative prediction of microvascular invasion in hepatocellular carcinoma.","authors":"Jianhao Zhang, Desheng Chen, Yutao Chen, Kang Yao, Xing Lyu, Linda Fan, Chenghao Zhao, Yongwei Hu, Kaiming He, Haobin Sun, Yufeng He, Wenjie Zheng, Yingcai Zhang","doi":"10.1097/MEG.0000000000003224","DOIUrl":"10.1097/MEG.0000000000003224","url":null,"abstract":"<p><strong>Aim: </strong>Microvascular invasion (MVI) is a key predictor of recurrence in hepatocellular carcinoma (HCC), but it is diagnosed pathologically after surgery. We aimed to develop and validate a simplified preoperative nomogram using routine markers and tumor burden score (TBS).</p><p><strong>Methods: </strong>This retrospective study included 512 patients with HCC who underwent radical hepatectomy between June 2018 and 2023 (309 MVI-negative and 203 MVI-positive). Predictors were selected by univariate analysis and least absolute shrinkage and selection operator regression. Multivariable logistic regression was used to construct the model. Discrimination, calibration, and clinical utility were assessed using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis. An interactive dynamic nomogram was developed from the final model.</p><p><strong>Results: </strong>The nomogram incorporated dichotomized aspartate aminotransferase (≥29.5 U/L), platelet count (≥127.5 × 10 9 /L), and alpha-fetoprotein (≥400 ng/ml), and TBS modeled as a continuous variable with restricted cubic splines. The model showed good discrimination (AUC = 0.720), good agreement between predicted and observed probabilities, and meaningful net benefit when the threshold probability exceeded 20%.</p><p><strong>Conclusion: </strong>This simplified dynamic nomogram provides a practical noninvasive tool for preoperative MVI risk assessment and may support individualized decision-making in patients with HCC.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1092-1100"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe cytomegalovirus gastritis and hypogammaglobulinemia in a patient treated with pembrolizumab.","authors":"Federico Sottotetti, Giovanni Arpa, Lucrezia Spina, Andrea Premoli, Katerina Vjero, Laura Deborah Locati, Marco Vincenzo Lenti","doi":"10.1097/MEG.0000000000003231","DOIUrl":"10.1097/MEG.0000000000003231","url":null,"abstract":"<p><p>A 66-year-old man with stage IVB oesophageal carcinoma treated with cisplatin, 5-fluorouracil, and pembrolizumab developed gastric erosions and ulcers with lymphoplasmacytic and neutrophilic infiltrates suggestive of immune checkpoint inhibitor-induced gastritis. High-dose steroids yielded transient relief. Cytomegalovirus (CMV) DNA was later found in gastric biopsies; steroids were withdrawn, and 3 weeks of intravenous ganciclovir led to partial improvement. Subsequent haemorrhagic gastritis raised concern for underlying immunodeficiency; serum immunoglobulin G (IgG), IgA, and IgM were undetectable. Administration of intravenous immunoglobulins (0.8 g/kg) produced rapid clinical resolution. This case report underscores the need for tissue-based CMV testing and cautious steroid use in severe gastritis.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1106-1109"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The natural history of hepatocellular adenoma: long-term outcomes from a large tertiary centre.","authors":"Evangelia Florou, Anushka Jindal, Mohammad Reza Fattahi, Nigel Heaton, Parthi Srinivasan","doi":"10.1097/MEG.0000000000003215","DOIUrl":"10.1097/MEG.0000000000003215","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular adenoma (HCA) is a benign liver tumour with variable biological behaviour and a recognised risk of haemorrhage and malignant transformation. Evidence on long-term natural history in mixed-management cohorts remains limited. This study reports clinical features, radiological behaviour and outcomes from a large tertiary centre.</p><p><strong>Methods: </strong>A retrospective review was undertaken of all radiologically or histologically confirmed HCAs over a 17-year period. Diagnosis was based primarily on cross-sectional imaging, with biopsy reserved for atypical lesions. Patients were managed with surveillance, resection or transplantation.</p><p><strong>Results: </strong>From 2005 to 2022, 164 patients were identified, predominantly female (86.6%) with a median age of 36 years. Risk factors were present in 78.7%, most commonly oral contraceptive exposure and metabolic syndrome; syndromic disease accounted for 7.3%. Most tumours were incidental (70.7%); rupture occurred in three patients (1.8%). Histology ( n  = 86) showed inflammatory HCA as the most common subtype (40.7%), followed by hepatocyte nuclear factor 1a-mutated (24.4%) and β-catenin-mutated (8.1%). Surveillance was the main strategy (76.2%), with radiological regression in 18%. Resection was undertaken in 23.8% and transplantation in 5.5%. Malignant transformation occurred in six cases (3.7%), all within β-catenin-mutated or inflammatory adenomas.</p><p><strong>Conclusion: </strong>Most HCAs were safely managed with surveillance, while malignant transformation was rare and restricted to high-risk molecular subtypes, supporting a conservative, risk-stratified approach.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1083-1091"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary modulation of transient receptor potential vanilloid 1 as a potential therapeutic target in irritable bowel syndrome and other disorders of gut-brain interaction.","authors":"Nicola Siragusa, Andrea Costantino, Gloria Baldassari, Alessandra Dell'Era","doi":"10.1097/MEG.0000000000003238","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003238","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 9","pages":"1110-1111"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated glucose disposal rate anrd mortality prediction in metabolic dysfunction-associated steatotic liver disease.","authors":"Aarij Sohail Iqbal, Hashim Nawaz","doi":"10.1097/MEG.0000000000003243","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003243","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 9","pages":"1115"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colitis cystica profunda: a systematic review.","authors":"Thomas Stirrat, Deeptha Bejugam, Joseph Alukal, Priyanka Kanth","doi":"10.1097/MEG.0000000000003150","DOIUrl":"10.1097/MEG.0000000000003150","url":null,"abstract":"<p><p>Colitis cystica profunda (CCP) is an uncommon, benign colorectal lesion that can mimic malignancy. We conducted a systematic review of histologically confirmed CCP case reports and series to define epidemiology, presentation, diagnostic yield, management, and outcomes. Following PRISMA 2020, Embase, PubMed/MEDLINE, Web of Science, and CINAHL were searched (1965-2025); two reviewers independently screened studies and extracted demographic, clinical, imaging, histologic, treatment, and outcome data. Sixty-five studies (92 patients) met criteria. Mean age was 40 ± 12 years (median 39), and 54% were male. Rectal bleeding (70%), mucus discharge (32%), diarrhea (24%), and abdominal/rectal pain (26%) were most common; 12% were asymptomatic. Lesions were predominantly distal (rectum 61%), and superficial biopsies reached the submucosa in only 32%, contributing to frequent sampling error; Endoscopic ultrasound (EUS) and cross-sectional imaging typically showed submucosal cystic lesions with intact muscularis propria. Conservative and medical therapy were each attempted in 16% of patients, endoscopic resection in 14%, and surgery in 67%, most commonly local transanal/perineal excision (40% of surgeries) or segmental/partial colectomy (32% of surgeries). Dysplasia was reported in 10% and coexisting invasive adenocarcinoma in 4% at diagnosis; no subsequent malignant transformation was reported over a median follow-up of 8.4 months. Post-operative morbidity occurred in 5% and recurrence in 4%. CCP is a rare but important mimic of colorectal cancer; diagnosis is optimized with deep tissue sampling and high-resolution imaging. When feasible, organ-preserving endoscopic or local excision can achieve durable symptom resolution with low morbidity while avoiding unnecessary radical surgery.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 9","pages":"1001-1007"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fully covered metal stents as a risk factor for acute cholecystitis in patients with biliary stricture: a multicenter retrospective study.","authors":"Tawfik Khoury, Ariel A Benson, Mor Goldsztein, Nama Mubariki, Adi Nubani, Tomer Greener, Halim Awadie, Mahmud Mahamid, Andrea Lisotti, Wisam Sbeit","doi":"10.1097/MEG.0000000000003192","DOIUrl":"10.1097/MEG.0000000000003192","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the prevalence and risk factors for acute cholecystitis following the placement of fully covered self-expandable metal stents (FC-SEMS) during endoscopic retrograde cholangiopancreatography into the common bile duct (CBD), across patients with various indications. We aimed to evaluate whether FC-SEMS placement increases the risk of acute cholecystitis and to identify associated risk factors.</p><p><strong>Methods: </strong>In this retrospective, multicenter study, 365 medical records from multiple hospitals were reviewed. All patients underwent FC-SEMS placement for biliary strictures. Demographic and clinical data, including complications, were collected. Logistic regression analysis was performed to assess associations between acute cholecystitis and variables such as gallbladder stones, CBD stones, CBD diameter, and stent length.</p><p><strong>Results: </strong>Acute cholecystitis occurred in 8.8% of patients. On univariate analysis, the presence of gallbladder stones and smaller CBD diameter were significantly associated with increased risk of acute cholecystitis ( P  = 0.01 and P  = 0.02, respectively). Shorter stents (40-60 mm) were associated with a markedly higher incidence of acute cholecystitis (10.4%) compared to longer stents (70-100 mm) (1.5%; P  = 0.02). Multivariate logistic regression revealed that gallbladder stones (odds ratio: 4.2; 95% confidence interval: 1.76-9.85; P  = 0.001) and reduced CBD diameter (odds ratio: 0.88; 95% confidence interval: 0.79-0.98; P  = 0.02) independently predicted acute cholecystitis among the subgroup of patients with 40-60 mm long stents. Patients who developed acute cholecystitis had significantly longer follow up durations (279.5 vs. 176.8 days; P  < 0.05).</p><p><strong>Conclusion: </strong>FC-SEMS placement, particularly with shorter stents, is associated with an increased risk of acute cholecystitis, especially in patients with gallbladder stones and narrower CBD diameters. These findings underscore the need for careful patient selection, individualized stent sizing, and extended follow up in high-risk populations.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1036-1040"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}